| NPI | 1992014807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIARA N REED Co Owner 757-593-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 1849-05-001) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 1849-05-001) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2015-02-12 |